Acute renal failure in cardiothoracic surgery patients: what is the best definition of this common and potent predictor of increased morbidity and mortality

被引：19

作者：

Falvo, Anthony ^{[1
]}

Horst, H. Mathilda ^{[1
]}

Rubinfeld, Ilan ^{[1
]}

Blyden, Dione ^{[1
]}

Brandt, Mary-Margaret ^{[1
]}

Jordan, Jack ^{[3
]}

Faber, Mark D. ^{[2
]}

Silverman, Norman ^{[1
]}

机构：

[1] Henry Ford Hosp, Dept Surg, Detroit, MI 48202 USA

[2] Henry Ford Hosp, Div Nephrol & Hypertens, Detroit, MI 48202 USA

[3] Henry Ford Hosp, Dept Qual & Safety, Detroit, MI 48202 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2008年 / 196卷 / 03期

关键词：

renal failure; acute renal failure; cardiothoracic surgery; renal replacement therapy; creatinine;

D O I：

10.1016/j.amjsurg.2007.08.066

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: Universal agreement on criteria for acute renal failure (ARF) is lacking. The purpose of the current study was to determine which of 6 definitions for ARF best predicted clinical outcomes in postoperative cardiothoracic surgery (CTS) patients. METHODS: Criteria for ARF were retrospectively applied to 1,085 CTS patients. General linear models analyzed length of stay (LOS) and ventilator days with logistic regression for mortality. RESULTS: Thirty-seven percent of patients met at least 1 of 6 definitions of ARF. For each 1-mg/dL increase from the initial creatinine, LOS increased by 6.96 days, ventilator days increased by 3.58 days, and mortality increased by 2.23 times (P <.0001). CONCLUSIONS: One definition that best predicted ARF was not found. ARF was a significant independent predictor of increased mortality, LOS, and ventilator days. Even small increases in creatinine correlate with clinically significant worsening of expected outcomes. (c) 2008 Elsevier Inc. All rights reserved.

引用

页码：379 / 383

页数：5

共 14 条

[1] Renal failure predisposes patients to adverse outcome after coronary artery bypass surgery [J].